Gabatarwa
Babban alamun cutar basir shine jini a cikin stool, ciwon dubura, faɗuwa da ƙaiƙayi da sauransu, waɗanda ke tasiri sosai ga ingancin rayuwa.A cikin lokuta masu tsanani, yana iya haifar da basur da ke daure da kuma anemia na kullum wanda jini a cikin stool ya haifar.A halin yanzu, magani na ra'ayin mazan jiya ya dogara ne akan magunguna, kuma ana buƙatar maganin tiyata a lokuta masu tsanani.
Maganin Endoscopic sabuwar hanyar magani ce da aka haɓaka a cikin 'yan shekarun nan, wanda ya fi dacewa da asibitocin tushen ciyawa.A yau, za mu taƙaita kuma mu daidaita.
1. Asibiti na asibiti, anatomy da maganin basur a baya
Ganewar Basir
Ganewar ciwon basir ya dogara ne akan tarihi, dubawa, duban duburar dijital da kuma colonoscopy.Dangane da tarihin likitanci, wajibi ne a fahimci ciwon tsuliya, jini a cikin stool, zubar basir da sake dawowa da sauransu. Binciken ya fi fahimtar bayyanar basir, ko akwai fistula na tsuliya na kumburin perianal da sauransu, da kuma duburar dijital. jarrabawa yana buƙatar fahimtar maƙarƙashiyar dubura da ko akwai induration.Colonoscopy yana buƙatar sanin wasu cututtuka irin su ciwace-ciwacen ƙwayoyi, ulcerative colitis, da dai sauransu waɗanda ke haifar da zubar jini.Rabewa da darajar basur
Basir iri uku ne: Basir na ciki, basir na waje, da cakudewar basir.
Basir: Ciki, Na waje, da Gauraye Basir
Ana iya rarraba basur zuwa maki I, II, III, da IV.Ana kimanta shi gwargwadon cunkoso, zubar basir da dawowa.
Alamu don maganin endoscopic sune maki I, II, da III na ciki na ciki, yayin da basir na ciki na aji IV, basur na waje, da kuma gauraye basur suna da alaƙa ga maganin endoscopic.Layin raba tsakanin jiyya na endoscopic shine layin hakori.
Anatomy na basur
Layin tsuliya, layin haƙora, kushin tsuliya, da basur sune ra'ayoyi waɗanda masu ilimin endoscopists ke buƙatar sanin su.Ganewar Endoscopic yana buƙatar ɗan gogewa.Layin haƙora shine mahaɗar tsuliya squamous epithelium da columnar epithelium, kuma yanki na tsaka-tsaki tsakanin layin tsuliya da layin haƙori yana rufe ta epithelium columnar amma ba jiki ya shiga ciki ba.Sabili da haka, maganin endoscopic yana dogara ne akan layin hakori.Ana iya yin maganin endoscopic a cikin layin haƙora, kuma ba za a iya yin maganin endoscopic a waje da layin haƙori ba.
Hoto 1. Duban gaba na layin hakori a ƙarƙashin endoscope.Kibiya mai launin rawaya tana nuni zuwa layin haƙora serrated na annular, farar kibiyar tana nuni zuwa ga ginshiƙin dubura da cibiyar sadarwa ta jijiyar tsayi, sannan jan kibiya tana nuni zuwa ga bawul ɗin tsuliya.
1A: hoton haske fari;1B: Hoto Hasken Narrowband
Hoto 2 Lura da maƙarƙashiyar tsuliya (kibiya mai ja) da ƙananan ƙarshen ginshiƙin tsuliya (fararen kibiya) tare da na'urar hangen nesa.
Hoto 3 Duban papilla na tsuliya tare da microscope (kibiya rawaya)
Hoto 4. An lura da layin tsuliya da layin haƙora ta hanyar baya-bayan nan.Kibiyar rawaya tana nuna layin haƙora, kuma baƙar kibiya tana nuni zuwa layin tsuliya.
Abubuwan da ake amfani da su na papilla na tsuliya da ginshiƙin tsuliya ana amfani da su sosai a aikin tiyatar anorectal kuma ba za a sake maimaita su anan ba.
A classic jiyya na basur: akwai yafi mazan jiya magani da kuma m magani.Maganin masu ra'ayin mazan jiya ya haɗa da aikace-aikacen perianal na miyagun ƙwayoyi da sitz bath, kuma hanyoyin fiɗa sun haɗa da basur jini da tsattsauran ra'ayi (PPH).Saboda maganin tiyata ya fi dacewa, sakamakon yana da kwanciyar hankali, kuma hadarin yana da ƙananan, mai haƙuri yana buƙatar asibiti don kwanaki 3-5.
2. Maganin endoscopic na ciki
Bambanci tsakanin maganin endoscopic na ciki na ciki da maganin EGV:
Makasudin maganin endoscopic na cututtukan esophagogastric shine tasoshin jini na varicose, kuma makasudin maganin basir na ciki ba sauƙaƙan jini ba ne, amma basur wanda ya ƙunshi tasoshin jini da nama mai haɗawa.Maganin ciwon basir shine kawar da bayyanar cututtuka, ɗaga kushin tsurar da ke motsawa ƙasa, da kuma guje wa rikice-rikice irin su ciwon ciki wanda ke haifar da bacewar basur (ka'idar "kashe komai" yana da wuyar samun ciwon tsuliya).
Manufar maganin endoscopic: Don sauƙaƙe ko kawar da bayyanar cututtuka, ba don kawar da basur ba.
Jiyya na Endoscopic ya haɗa da sclerotherapy da band ligation.
Don ganowa da kuma kula da basur na ciki, ana amfani da colonoscopy don dubawa, kuma ana ba da shawarar gastroscope don magani.Bugu da ƙari, bisa ga ainihin halin da ake ciki na kowane asibiti, za ku iya zaɓar magani na waje ko na asibiti.
①Sclerotherapy (taimaka ta hanyar m hula)
Wakilin sclerosing shine allurar barasa lauryl, kuma ana iya amfani da allurar barasa kumfa lauryl.Hakanan wajibi ne a yi amfani da allurar submucosal na methylene blue a matsayin wakili da ya ɓace don fahimtar jagorancin kwarara da ɗaukar nauyin wakili na sclerosing.
Manufar hular gaskiya ita ce faɗaɗa fagen hangen nesa.Ana iya zaɓar allurar allurar daga allurar allurar mucosal na yau da kullun.Gabaɗaya, tsayin allurar shine 6mm.Likitocin da ba su da kwarewa sosai, ya kamata su yi ƙoƙari su guji yin amfani da dogon alluran allura, saboda dogayen allurar suna da saurin yin allurar ectopic da allura.Haɗari mai zurfi kuma yana haifar da ƙurar ƙura da kumburi.
An zaɓi wurin allurar sama da gefen baki na layin haƙori, kuma matsayin allurar yana a gindin basir mai niyya.Ana saka allurar a 30 ° ~ 40 ° a ƙarƙashin hangen nesa kai tsaye (gaba ko baya) na endoscope, kuma an saka allurar a cikin gindin basur.Ki yi tauri mai tauri a gindin basur, a janye allurar yayin yin allura, kamar 0.5 ~ 2mL, sannan a daina allurar har sai basir ya yi girma da fari.Bayan an gama allurar, duba ko akwai jini a wurin allurar.
Endoscopic sclerotherapy ya haɗa da alluran madubi na gaba da allurar madubi mai jujjuyawar.Gabaɗaya, allurar madubi da aka juyar da ita ita ce babbar hanya.
② maganin bandeji
Gabaɗaya, ana amfani da na'urar ligation mai nau'i-nau'i da yawa, ba fiye da zobe bakwai ba.Ana yin ligation a 1 zuwa 3 cm sama da layin haƙora, kuma yawanci ana fara ligation kusa da layin tsuliya.Yana iya zama ligation na jijiyoyi ko mucosal ligation ko haɗin haɗin gwiwa.Juyawa madubi ligation shine babbar hanyar, yawanci sau 1-2, tare da tazara na kusan wata 1.
Magani na wucin gadi: ba a buƙatar azumi bayan an yi aiki, kula da kwanciyar hankali, da kuma guje wa tsawan zama da aiki mai nauyi.Ba a buƙatar yin amfani da maganin rigakafi na yau da kullun.
3. Halin da ake ciki da kuma matsalolin da ake ciki na asibitocin tushen ciyawa
A da, babban matsayi na maganin basur ya kasance a sashin anorectal.Maganin tsari a cikin sashin anorectal ya haɗa da magunguna masu ra'ayin mazan jiya, allurar sclerotherapy, da magani na tiyata.
Mataimakin Oterscops ba su da matukar gogewa a cikin tantance ta Perianal uwarouly a karkashin Edentoscopy, da kuma alamomi na maganin kula da aikin tsallakewa ana iyakance su ne (kawai na ciki.Ana kuma buƙatar tiyata don samun cikakkiyar farfadowa, wanda ya zama wuri mai wahala a cikin ci gaban aikin.
A cikin ka'idar, maganin endoscopic na ciki na ciki ya dace musamman ga asibitoci na farko, amma a aikace, ba kamar yadda ake tsammani ba.
Mu, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., wani manufacturer ne a kasar Sin ƙware a cikin endoscopic consumables, kamarbiopsy forceps, hemoclip, polyp tarko, allurar sclerotherapy, fesa catheter, cytology goge, jagora, kwandon dawo da dutse, hanci biliary drainage catheterda dai sauransu waɗanda ake amfani da su sosai a cikin EMR, ESD, ERCP.Samfuran mu suna da takardar shedar CE, kuma tsire-tsire namu suna da takaddun ISO.An fitar da kayanmu zuwa Turai, Arewacin Amurka, Gabas ta Tsakiya da wani yanki na Asiya, kuma suna samun abokin ciniki yabo da yabo!
Lokacin aikawa: Jul-11-2022